Ajit Narayanan is a developer and new father! Out of compassion and interest, he founded Avaz Inc. to make an augmentative and alternative communication app (AAC) for kids with autism. He’s an electrical engineer and used to live and work in the Silicon Valley in the San Francisco Bay Area. In 2007, he moved back to India – the city of Chennai – and began working on technology for kids with special needs. At that time India had very little assistive technology, and he and his team built India’s first communication device. They called it Avaz, which is the Hindi word for speech. This device was VERY popular in india and they won an award from the President of India for inventing it. After the iPad came out, they converted Avaz into an app, and it’s now being used all over the world.
Possibly because living with autism is so much more challenging in India, we found out we had solved a lot of really challenging problems while building an app for India – and that’s why the app so popular in other countries too!
Before we find out more about your product, will you describe what Augmentative or Alternative Communication (AAC) is and why it is a breakthrough for those with autism?
Well, children with autism have difficulty with language and communication. The exact biology of this impairment is poorly understood, but it’s thought that many children on the spectrum find it difficult to “process” language – to convert spoken and written words into meaning and vice-versa. That’s why many children with autism are non-verbal, and even some who aren’t, turn out to have small vocabularies and difficulties communicating. Not being able to effectively communicate ones needs are often the root of behavior issues and meltdowns, and are also the primary reason why children with autism struggle with education.
In the last couple of decades, a major breakthrough was the discovery that many kids “think in pictures” and have strong visual intelligence. So it’s possible to design picture-based or symbol-based communication systems, which can help kids with autism express themselves even if they struggle with language.
Any system that is not speech – picture boards, keyboards, even sign language – can be considered alternative and augmentative forms of communication, or AAC. Today, the term is frequently applied to technology and apps that allow kids to communicate. A child with autism has to learn to use AAC to communicate the same way that we learn language, but for them, learning AAC is often much, much easier than learning spoken or written language.
I have seen some truly inspiring examples of how AAC has given children a voice. In the school where we first developed Avaz, the kids put up a school play every year, and it used to be that non-verbal kids would not be able to participate in these events. One year a teacher had this wonderful idea of having the kids use Avaz to deliver dialogues – the hero of that year’s play was a non-verbal child. I remember seeing the parents of that child watching their son on stage delivering his lines for the first time in his life – they were in tears – and I was too!
What is the current state of AAC research on its effectiveness and impact?
AAC has been put through the paces over the last few decades and it is now considered a standard tool in helping kids with autism communicate. Research has shown that the use of AAC early in a child’s life greatly promotes their ability to communicate, and may even speed up their ability to talk naturally. AAC has grown into a full-fledged research area, with its own publications and conferences and university programs; and with the introduction of the iPad as an AAC device, it has seen a lot of very exciting innovation. I’m good friends with many of the top researchers in AAC worldwide, and I can say first-hand that we’re living in the golden age of AAC.
Tell us about AVAZ…What is it and how long did it take you to develop it?
Avaz is a completely new take on AAC. When we started digging a bit deeper into how our older AAC app was being used, we found that it was mostly therapists who lead AAC implementation. Now, a typical speech therapist sees a child for maybe one hour a week; but communication happens “in the mess of everyday life,” and unless children’s language skills are stimulated many, many times a day, they will struggle to develop communication skills. The best therapists spend as much time training parents and teachers to continue stimulating a child’s communication as they do training a child. Until now, there was no app that was accessible to non-professionals – Avaz is the first app that combines a speech app for a child, and a training app for a parent or teacher to integrate it into a child’s daily life.
The process of developing Avaz started in early 2014. It was motivated by the extreme paucity of speech therapists in India: there are only 1,500 therapists in the entire country! To give you context, there are 150,000 in the USA and India has 3 times as many people as the USA does. We had to build an app that parents could use to help their kids develop communication, and that was the start. We worked with about 35 families – 20 in India, about 15 in California – and built the app over a period of about a year.
Who is the ideal user?
I would say the ideal user is the parent of a child diagnosed with autism and who is either non-verbal or has significant difficulties with language and communication. And the earlier the better, so we see a lot of children who are between 3-8 years using the app. That’s the ideal child user. The ideal parent user is someone who believes in their child, who trusts the research that says their child has the capability to have complex and wonderful thoughts, and who would like to complement at home the work their speech therapist does in therapy.
You call out 5 key areas that makes AVAZ stand out—vocabulary, customization, tracking, activities, and communication adventures. Can you give us an example of each?
Vocabulary: Avaz is a child’s “voice” – so it needs to have all of the words that a child would use in daily life, organized in a way that is easily learnable by the child. Avaz’s vocabulary stresses the “core” vocabulary – the little words that make up 80% of our conversation – and has 3 different levels so that it can grow with the child.
Customization: Because every child has words that are unique to their lives – the food they like, the people in their life, the places they go to, the toys they play with – it’s necessary to customize any AAC app to add those words into the app. In most apps, it’s really hard to add new words to them – it requires a therapist to do it, and even a therapist needs to take a half-day workshop to figure it out! On Avaz, you can add a word in 10 seconds, and teach a parent to do it in 5 minutes; and you can add symbols, words, voice recordings, and photographs to the vocabulary.
Tracking: A major feature in speech therapy is what’s called “evidence-based practice” – the therapy should show measurable, tangible results. Avaz provides a lot of data and analytics to therapists so that when they see a child, maybe once a week, they know exactly where the child’s language is growing and where it are not. They can then use this data to make appropriate interventions. Avaz is the only app that does this well.
Activities: The lynchpin of Avaz parent strategy is a very simple idea: the idea that if you want your child to communicate using Avaz, you need to communicate to your child using Avaz, too. A child with special needs learns to communicate the same way a typically developing child does – by imitating parents. So how does a parent communicate using Avaz? The approach we take is to guide the parent to integrate Avaz into a child’s life one activity at a time – during mealtimes, playtime, story time – until the child is communicating through the entire day. For each of these activities, Avaz provides the parent example conversations, guidance on how to have those conversations using Avaz, and strategies to get their child communicating well.
Communication adventures: We wanted parents using Avaz to “think like a therapist”. Speech therapy is pretty complex – a therapist has a whole bunch of ‘strategies’ that they use to build a child’s intent to communicate and to grow a child’s vocabulary. Avaz teaches the most important of these strategies to a parent through a mini-game called Communication Adventure. The hero of these Adventures is a 7-year-old non-verbal kid called Johnny, and the objective of the game is to get Johnny to communicate by choosing the most appropriate action or sentence to speak to him. Avaz provides the parent with positive and negative feedback, so that they eventually become communication experts!
Is it available on Apple and Android devices?
Avaz is available for the iPad. The original Avaz is available on Android as well, and we do intend to support the Android platform for Avaz Together soon.
What does it cost?
It’s available to download for free, and works without any limitations for 1 month. After that, it’s a $9.99/mo subscription. We’re also preparing a version for one-time purchase, which will probably be priced at $199.
What is your greatest wish for AVAZ ?
I think that a large part of the joy of childhood is the joy of those little moments of bonding and communication and learning. Too many children with special needs miss out on those opportunities. My greatest wish for Avaz is for it to help parents help their children live positive, fuller lives by putting those communication opportunities back in their lives!
Do you have any stories to share about how it has made a difference?
We’re continually surprised by how empowering parents can change children’s lives. My favorite story about Avaz was told to me by a therapist who we work with in India – she moved back from Boston to Mumbai, and I think she is one of the best therapists in India. She had this one client who came to her all the way from Nigeria – an expat Indian family – and told her, we only come to India once a year but we’d like you to conduct 4, maybe 5 therapy sessions for our son over the course of this week, because that’s all the time we will be here in India! Instead of doing that, she gave the parents Avaz, and spent an hour teaching the parents how to help their child use it. The next time she met the parents, she was astounded by how much of work they had done with the app – and amazed by how communicative their son had become – all that without any formal therapy at all!